For a long time, some people only focus on diabetes and often ignore the complications of diabetes. In fact, the terrible thing about diabetes is not the disease itself, but the complications it brings.
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A hot towel almost led to an amputation!
Recently, the WeChat public account of Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine shared a patient case to remind everyone to pay attention to diabetes complications. ①
Mr. Zhang, 67, is a 20-year-old diabetic. In the first month, the family dressed up and took the high-speed train for 6 hours to go to a relative's house to drink wedding wine, and the next day also took the high-speed train for 6 hours to go home. When I got home and took off my leather shoes, I saw that the fourth toe of Mr. Zhang's left foot was red, and there was a blister on a closer look.
The family was worried that the wound would not heal, so they scalded a towel with boiling water and gave Mr. Zhang's wound a warm compress. After a few days, the wound did not heal, but became darker and darker, and the surrounding circle became more and more red and swollen.
So he hurriedly took Mr. Zhang to the Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. The doctor's diagnosis for Mr. Zhang was type 2 diabetic foot gangrene, referred to as diabetic foot.
Diabetic foot is one of the most serious complications of diabetes. Wu Weiwei, chief physician of the Department of Vascular Surgery at Tsinghua Changgung Hospital in Beijing, pointed out in an article in the Health Times in 2016 that blood sugar control is not ideal, and when there is a wound on the foot, it is likely to develop into a diabetic foot ulcer. Once the site of the diabetic foot ulcer is blackened and necrotic, it gradually spreads and expands, and skin necrosis occurs. At this time, the necrotic tissue on the foot generally cannot be repaired and can only be amputated. ②
Even more terrible than diabetes are diabetes complications
Diabetes itself is not fatal, but fatal is a serious complication! Heart attack, stroke, limb necrosis, and blindness can all be serious consequences caused by diabetes complications!
Wang Yi, an attending physician in the Department of Endocrinology at Huashan Hospital Affiliated to Fudan University, published an article on the hospital's WeChat public account in 2023 to suggest a number of common diabetes complications. ③
1. Cardiovascular disease
Cardiovascular disease in diabetics is also the leading cause of death in diabetic patients. Diabetes mellitus is an independent risk factor for cardiovascular disease, which means that even if you do not smoke or drink alcohol, are not obese, have no family history of cardiovascular disease, and have normal blood pressure and lipids, the risk of cardiovascular disease increases with diabetes. ③
2. Kidney lesions
High blood sugar can cause abnormal increases in the microcirculatory filtration pressure of the glomeruli, which can lead to kidney disease. ③
3. Retinopathy
Retinopathy is a common chronic complication of diabetes, which can be asymptomatic in the early stages, and as the disease progresses, it can lead to repeated fundus bleeding, significant vision loss, and in severe cases, blindness. It is also a leading cause of blindness in adults. Diabetic retinopathy, particularly proliferative diabetic retinopathy, is a complication specific to diabetes. ③
4. Ketoacidosis
Diabetic ketoacidosis is the most common acute complication of diabetes mellitus, which is a clinical syndrome caused by insulin deficiency, inability to utilize glucose in the body, and a large number of ketones produced by the decomposition of large amounts of fat, with hyperglycemia, hyperketonemia (blood ketones ≥ 5 mmol/L) and metabolic acidosis as the main symptoms. Diabetic ketoacidosis is one of the most common emergencies, and once it occurs, it must be treated aggressively, otherwise it can be life-threatening. ③
5. Cognitive decline
Wu Donghong, chief physician of the Department of Endocrinology of the First Hospital of Harbin City, Heilongjiang Province, pointed out in an article in the Health Times in 2019 that the reason why diabetes causes cognitive decline and Alzheimer's disease is that high blood sugar will cause the hippocampus in the brain to become smaller, and then a series of cognitive dysfunction problems. In addition, if the sugar friend is combined with vascular disease, it may cause cerebral arteriosclerosis, causing ischemia and hypoxia of brain tissue, thereby causing dementia. ④
6. 听力丧失
Wu Donghong said that deafness is extremely common in diabetic patients, especially those who have been complicated by peripheral neuropathy and coronary heart disease. Hearing loss in diabetes mellitus often has a slow onset and is not easy to detect, and the condition will gradually worsen irreversibly, with limited clinical efficacy. Diabetes can affect auditory pathways in a variety of ways, causing alterations in hearing. ④
7. Osteoporosis
Wu Donghong said that the risk of hip fracture is 20% higher than that of normal people. This is because high blood sugar can cause increased excretion of urinary calcium and phosphorus, and at the same time lead to mild increased secretion of parathyroid hormone; ④
8. Periodontitis
Chen Zhuo, director of the Department of Stomatology at Zhengzhou Central Hospital in Henan Province, pointed out in an article in Health Times in 2019 that at present, periodontitis has been listed as a complication of diabetes, and periodontitis and diabetes are mutually reinforcing.
The incidence of periodontal disease in diabetic patients is high, because the persistent hyperglycemic state of diabetic patients provides rich nutrients to the bacteria in their gums, resulting in microvascular blockage of gum tissue, which is easy to cause oral infection. ⑤
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There are only three steps from normal blood sugar to diabetes
Many sugar lovers will ask, "Why did you suddenly get diabetes?" The answer is: diabetes doesn't happen suddenly. It usually takes several years to go from normal blood sugar to impaired glucose tolerance to the onset of diabetes.
Zhou Ting, deputy chief physician of the Department of Endocrinology of Peking Union Medical College Hospital, recently said in his personal WeChat public account that the development of diabetes is a chronic process, and there can be no manifestations in the early stage, insulin resistance and secretion dysfunction may exist, and the natural course of diabetes can be divided into three stages:
Stage 1: The islet β cells are in the compensatory phase, a stage in which β cells maintain normal blood sugar levels by increasing insulin secretion due to insulin resistance.
Stage 2: Insulin β cells maintain function but decrease in quality, β cells can still maintain a certain function, but the number of β cells begins to decrease, resulting in a gradual decline in insulin secretion capacity.
Stage 3: The irreversible impairment of pancreatic β cell function, in which the ability of β cells to respond to glucose stimulation is irreversibly impaired, and insulin secretion cannot maintain blood glucose homeostasis, resulting in type 2 diabetes.
The process from normal blood sugar to diagnosis of diabetes is relatively long, 5~10 years, or even longer. Reversing diabetes usually means maintaining blood sugar within a certain range, but it is no longer possible to restore the function of pancreatic islet β cells. ⑥
Control diabetes, do these things well in life!
1. Eat regularly and control the total amount
The "Dietary Guidelines for Adults with Diabetes (2023 Edition)" points out that regular meals, regular and quantitative meals, are the basis for maintaining blood sugar stability. Regular meals refer to three meals a day and a relatively fixed time for additional meals, and regular and quantitative meals can avoid overeating caused by sluggish response of the satiety center caused by excessive hunger. Don't overeat, don't eat snacks and drinks at will, don't eat more meals, and reduce the number of meals.
2. Adjust the order of eating
The results of a study published in Clinical Nutrition in 2020 showed that the vegetable-protein-carbohydrate meal sequence was the most effective in controlling blood sugar after meals. ⑦
That is, eat vegetables, meat, eggs, and soy products first, and finally eat staple foods. If you can't accept eating vegetables empty, you can eat a bite or two of vegetables, then a bite of meat, and finally a little more food.
3. Control weight and reduce waist circumference
If you increase your weight and waist circumference at the same time, you will have a higher risk of high blood pressure, dyslipidemia, coronary heart disease, and diabetes.
Qu Shen, chief physician of the Department of Endocrinology of Shanghai Tenth People's Hospital, said in an article in Health Times in 2019 that the incidence of type 2 diabetes in overweight and obese patients is 2~5 times higher than that of normal weight patients. Measuring body weight regularly and preventing overweight and obesity can prevent 38% of diabetes cases. ⑧
4. If you can walk, don't sit
According to the Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition), regular exercise can not only help lower blood sugar, but also increase insulin sensitivity, improve physical fitness, reduce cardiovascular risk factors, and prevent a variety of complications.
It is recommended to adhere to regular aerobic exercise, such as brisk walking, jogging, cycling, skipping rope, etc., lasting ≥ 45 minutes, which can improve blood sugar management in patients with type 2 diabetes, mainly help lower blood sugar, and can also play a weight loss effect and improve insulin resistance.
5. Less stress and go to bed early
Mu Yiming, chief physician of the Department of Endocrinology of the First Medical Center of the PLA General Hospital, said in an interview with Health Times in 2014 that the body's hormones have their own laws of change, and these hormones will be in a state of stress when they are not sleeping or stressed, resulting in changes in hormone levels. These hormone levels are antagonistic to insulin, and over time, the balance with insulin will be disturbed, resulting in human fat metabolism, blood sugar metabolism, and neuroimmune system disorders, which may lead to diabetes. ⑨
This article is synthesized from:
(1)2024-04-01Sir Run Run Shaw Hospital "The distance from the amputation, only a hot towel!5-year mortality rate is as high as 40%"
(2)2016-08-26Health Times "Diabetic Foot How to Avoid Amputation"
(3)2023-12-14Huashan Hospital Affiliated to Fudan University "How many complications of diabetes do you know?"
(4)2019-10-25Health Times "Complications Rarely Thought of by Sugar Friends"
(5)2019-03-05Health Times "Periodontitis is a complication of diabetes"
(6)2024-03-31Zhou Yijian, "There is new evidence for prediabetes, which provides guidance for us to prevent or reverse hyperglycemia"
⑦Sun, L.,Goh, H. J., Govindharajulu, P., Leow, M. K. S., & Henry, C. J. (2020). Postprandial glucose, insulin and incretin responses differ by test mealmacronutrient ingestion sequence(PATTERN study). Clinical Nutrition, 39(3),950-957.
(8)2019-04-19Health Times
(9)2014-08-18Health Times
Source: Health Times